Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 2089632 | FL |
NPI | 1255344784 |
---|---|
Provider Name | Valerie Wells |
First Address | Cooper City, FL 33330-4413 |
Second Address | Miami, FL 33136-1005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 08/07/2007 |